A problem solving approach is a process of planning care for a patient (McFerran and Martin, 2003) using ASPIRE, based on APIE (Yura and Walsh, 1988); Assessment, Plan, Implementation and Evaluation. ASPIRE is a nursing process which includes six stages: assess, a systematic nursing diagnosis, plan, implement, recheck and evaluate (Barrett et al, 2012). Using a range of assessment tools, some potential risks can be identified although, these tools should be used as guidance for treatment and not used in the decision making process as to who and who does not receive treatment, (National Institute for Health and Care Excellence (NICE), 2011) but through gaining consent during each process, as it should be before any care or treatment (NMC, 2008).
The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and
The ‘APIE’ framework consists of Assess, plan, implement and evaluate, the nursing process should include nursing diagnosis and recheck (Barrett et al 2009). Therefor the ‘ASPIRE’ framework was used to create Kora’s care plan, which is as follows assess, systematic nursing diagnosis, plan, implement, re-check and evaluate (Wilson et al, 2014). The problem of SOB had affected Kora’s oxygen saturation level assessment and this needed to be acted upon promptly as it could quickly be detrimental to the patient’s health. The nurse caring for Kora completed the local trust single assessment process (SAP) holistic assessment document to gather a range of information about Kora and her medical history, if the patient had any dependant relatives, “presenting complaint, concerns, current medications and social history” (Bennett et al, 2009). This enabled the nurse to gather information which could be incorporated into Kora’s care plan. Furthermore, it highlighted that the patient was worried about the care of dependant grandchildren, which could impact on the patient’s wellbeing. Treatment and care should take into account patients' needs and preferences. People with COPD should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals (Nice, 2010).The SAP 1 documentation the nurse involved in Kora’s care completed incorporated RLT
Mrs Gale is a 70 year old widow and retired unskilled worker. The patient lives alone and relies on her son to provide basic care, medication and meals. Mrs Gale has a history of weight fluctuation owing to lifestyle but is currently at risk of malnutrition due to Parkinson’s disease. Mrs Gale shows signs of early dementia and suffers from poor mobility and pain caused by arthritis. Mrs Gale also has mild depression triggered by loss and has become socially isolated. All names have been changed as per the Nursing and Midwifery Council confidentiality guidelines (2008).
In order to maintain confidentiality I have provided my client with a pseudonym (Nursing and Midwifery Council, 2002).
The healthcare industry has intensely advanced throughout the world, in turn changing the principles that incorporate the practice and culture of nursing practice. Altering the model of care to a patient-centered mode signifies an organizational culture shift and requires the participation of executives at the senior level (Cliff, 2012). To practice this care to provide the best care possible, it goes beyond the nurse to all healthcare professionals and senior leadership. The days of patients and nurses following a physician’s order without favor to care has now loaned themselves to more of an interdisciplinary approach to practice. Though, it is encouraged that the patient makes decisions for themselves, after receiving the proper education and information on their condition. Part of the patient-centered care is to be the patients’ advocate, by letting them know you are there for them when they are unable to speak and advocate for themselves and what is in their best interest. That goes in hand with educating them on “self-management of care, health literacy, patient, and family education through nurse-patient communication and interaction (Finkelman & Kenner, 2016, p. 271).”
The first stage of the process is assessment. Roper et al (2001) refer to this process as ‘assessing’ indicating an ongoing activity; this encourages nurses to recognise the on-going nature of this initial phase. The assessing stage includes gathering information about a patient, reviewing this information, identifying actual and potential problems and prioritising (Roper et al 2001). Roper et al (2001) explain the importance for assessing, as early as possible in the patient’s stay. Extensive, in-depth information may not be gathered on an initial assessment, however any information obtained contributes towards individualised care (Roper et al 2001). Ambrose and Wittig (1998) explain that the initial assessment becomes a foundation for ongoing assessing and holistic care. Barrett, Wilson and Woollands (2009) concord with Roper et al and Wittig in that assessing is an ongoing process and elaborate on this explaining that assessment should not be confused with admission. They state “an admission tends to be a one-off process when you first meet the patient, whereas assessment carries on throughout your relationship with the patient” (pg22). Assessment enables the nurse and patient to identify actual and potential problems. Although, some problems can be directly related to biological needs, holistic needs must be considered, i.e. psychological state and cultural/social standing
In this assignment we will be discussing how the Nursing and Midwifery Council NMC (2015) guides nurses in the direction of good practice. Why we have the code? Who the code is for? How to implement the code in our daily lives as practitioners. The NMC (2015) is a set of guidelines which nurses and midwives must adhere to in order to provide the best care possible to their patients. The NMC (2015) is split into four main sections:
The aim of this essay is to demonstrate the assessment process of a patient using the Roper Logan and Tierney (RLT) model of nursing framework and to show how the nursing process works alongside this model. This will be shown by a holistic history of the patient being shown, followed by how the RLT model is applicable to this patient. This is then followed by one nursing intervention being discussed showing how the nursing process is applied to patient care. The patient will be referred to as Mr Frederick Valentine to protect the patient’s anonymity as stated in the Nursing and Midwifery Council Code of Conduct (2008) guidelines.
The patient was last seen in the office in February. Please see that note for complete details. She has several issues she would like to discuss today. She tells me that she has really been under a lot of stress of late. She had been caring for her sister, who has uterine cancer. In addition, her husband 's brother recently died, and there have been issues regarding a property they co-owned. She sold her house in New York and is now renting a house here in Portsmouth. She feels all that she has been doing is moving and cleaning. She feels that she is a little bit settled, however and is hoping that she can get back to her normal regimen. She has not been walking as much as typical, and she would like to lose a couple of pounds and plans to get back into that, as well as her physical therapy exercises that she has been doing for her neuropathy.
The decision to work towards becoming a registered nurse requires a personal transition from the role of being an aerospace technician to one of a healthcare professional. As part of this transition, I must learn what defines a nurse, understand what I can contribute to the profession, establish and meet professional goals, and be aware of extraneous factors that affect the healthcare industry.
Since the early 1900’s nurses have been trying to improve and individualise patient care. In the 1970s this became more structured when the nursing process was introduced by the general nursing council (GNC), (Lloyd, Hancock & Campbell, 2007) .By doing this their intentions were to try and understand the patient in order to give them the best care possible (Cronin & Anderson, 2003). Through the nursing process philosophy care plans were written for patients. It was understood that this relationship would ensure the patient received the best care possible to suit them individually. This would consist of not just the patient as a physical being but their spiritual emotional and holistic being also (Cutler, 2010). The
Nursing is a complicated profession requiring a broad knowledge base, discipline, and a deep desire to understand and interpret scientific data with a goal of obtaining the best possible patient outcomes. This can be very difficult to achieve, requiring the nurse to process a variety of information, prioritize, and problem solve at a critical level (Wilkinson, Treas, Barnett, Smith, 2016). The nursing process is a scientific approach, utilized by nurses to systematically improve patient care by following five steps: assessment, diagnosis, planning, implementation, and evaluation (Wilkinson et al., 2016). A good nurse is someone who understands these phases, continues to build on them, and uses the information to create the best possible, individualized, healthcare plan for the patient. It is a mastery of art to find a way to include all of these concepts with so many diverse medical diagnoses. Having a structural way, such as the nursing process, paves a strong foundation for the nurse to maintain a patient centered approach to implement exceptional nursing care (Goncalves, Spiri, Ortolan, 2017).